Prostatic Artery Embolization for Control of Gross Hematuria in Patients with Benign Prostatic Hyperplasia: A Single-Center Retrospective Study in 20 Patients

Purpose: To evaluate the efficacy and safety of prostatic artery embolization (PAE) performed to treat gross hematuria secondary to benign prostatic hyperplasia (BPH). Materials and Methods: Between February 2014 and December 2017, 20 patients with gross hematuria secondary to BPH refractory to medical treatment underwent PAE in our institution. Technical success was defined as bilateral PAE. International Prostate Symptom Score (IPSS), quality of life (QoL), and clinical review were assessed before PAE and at 3 and 12 months after procedure. Short- and medium-term clinical successes were defined as, resolution of gross hematuria with no recurrence at 3 and 12 months, respectively. Results: Technical success rate was 100%. No major adverse events were recorded. Minor complications included gluteal pain, nausea, and fever in 7 patients. At 3 months, there were improvements in IPSS (21.1 +/- 6.6 to 9.8 +/- 4.7, P < .001) and QoL (5.1 +/- 1.7 to 2.4 +/- 1.3, P < .001). At 12 months, there were improvements in IPSS (8.1 +/- 2.5, P < .001) and QoL, (2.1 +/- 1.0, P < .001). At 3 months, recurrent hematuria was reported in 3 of 20 patients (85% short-term clinical success rate). One of the remaining 17 patients had developed recurrent hematuria by 12 months (80% medium-term clinical success rate). Conclusions: PAE is, a safe and effective means of treating gross hematuria caused by BPH refractory to medical treatment. PAE offers a reasonable option for such patients who are not suitable for surgical therapy.